主动脉壁间血肿的治疗与转归

The treatment choice and outcome of aortic intramural hematoma

目的：总结主动脉壁间血肿（aortic intramural hematoma,AIMH）的治疗选择与转归,以指导临床.方法：回顾分析北京大学人民医院2009年1月至2013年4月间,共收治AIMH患者16例,A型5例,B型11例.分析患者特征及治疗选择,电话及门诊随访确定治疗效果.结果：16例患者10例药物治疗,4例介入治疗,2例外科手术治疗,1例药物治疗患者死亡,其余患者均痊愈出院,随访1 ～48个月,平均13.3个月,1例失访,其余患者均存活.结论：AIMH是一组需要临床重视并积极治疗的主动脉病变,应根据其病理特征选择合适治疗方案.

Objective： Observe the treatment choice and outcome of aortic intramural hematoma （AIMH） and result of different treatment. Methods： Retrospective study the AIMH patients, analyze the char- acter and treatment choice of AIMH, follow patients by phone or interview to confirm the result. Results ： There were 16 AIMH patients treated in Peking university people＇ s hospital from January 2009 to April 2013. 5 cases were type A AIMH, 11 cases were type B AIMH. 10 cases were treated with medicine, 2 cases were treated with ascending aorta replacement and 4 cases were intervened with stent-graft, one patient （medicine group） died in hospital, the follow-up period is 1 -48 months [ mean （13.3± 12. 1 ） months ]. One patient failed to follow-up. The other patients are survived during the follow-up. Conclusion：AIMH is a kind of serious aorta disease, it can be treated by medicine, intervention or surgery according to its anatomic character.